Health CS Aden Duale. /ADEN DUALE/XHealth CS Aden Duale has appointed the NHIF Pending Medical Claims Verification Committee, marking the first step toward offsetting bills owed to health facilities.
The move is aimed at addressing the backlog of pending medical claims under the defunct National Health Insurance Fund (NHIF).
The committee's primary role will be to scrutinise and verify all pending claims accumulated between July 1, 2022, and September 30, 2024.
The committee is tasked with ensuring that claims are accurately verified and processed, while also identifying any fraudulent or corrupt activities.
The committee will be chaired by James Masiro Ojee with Anne Wamae serving as vice chairperson.
Members of the committee are Edward Kiplimo Bitok, Meshack Matengo, Meboh Atieno Awour, Tom Nyakaba, Catherine Karori Bosire, Paul Wafula, Catherine Mungania, James Oundo, Jackline Mukami Njiru, Judith Awinja and David Dawe.
The committee will also be supported by a secretariat headed by Peter Kitheka, along with several other staff members including Shawn Mogaka, Consolata Ogot, Emmanuel Ayodi Lusigi, Halima Yussuf and Wilbert Kurgat.
The team will operate under set terms of reference, which include scrutinising and analysing the pending claims, establishing criteria for examining their validity and making recommendations for their settlement.
The committee will also identify any fraudulent or corrupt claims and take appropriate action, while proposing reforms to prevent the future accumulation of such claims.
In addition to its primary mandate, the committee is empowered to carry out studies or research necessary to fulfill its duties.
It can also co-opt additional experts to assist in its work, ensuring a thorough examination of all claims.
The committee will operate with full access to previous reports relevant to its mandate and will regulate its own procedures for conducting business.
The team will be based at the Social Health Authority (SHA) building in Upper Hill.
The committee has been appointed to serve for a period of three months, starting from the date of the Gazette notice - March 28, 2025.
The formation of the committee comes at a critical time when the defunct NHIF has been facing challenges related to a backlog of medical claims, with healthcare providers and patients alike calling for quicker resolution.
